HR Advice Hub

What Does an Occupational Health Report Actually Tell Employers?

When an employee is referred to Occupational Health, managers can sometimes expect the report to give them a definitive answer about what to do next.

They might expect Occupational Health to confirm exactly what is wrong with the employee, decide whether they can continue in their job or tell the employer which adjustments they have to make. That isn't really the purpose of an Occupational Health report.

An Occupational Health report for an employer provides independent medical advice about how an employee's health may affect their work and how their work may affect their health. A good report should help an employer understand the situation and make an informed management decision, but it does not make that decision for them.

What Is an Occupational Health Report?

An Occupational Health report is usually produced following a referral from an employer and an assessment with the employee. The employer should provide relevant information about the employee's role, the reason for the referral and the particular questions they would like Occupational Health to consider. The clinician then assesses the employee and provides advice within the scope of that referral.

This is why the quality of the referral matters. Sending an employee to Occupational Health with very little information and simply asking whether they are "fit for work" may not give a manager the information they actually need.

If the real concern is repeated absence, whether particular duties can be performed, what support may help or whether a return to work is realistic, those questions should form part of the referral.

Will Occupational Health Tell the Employer the Employee's Diagnosis?

Sometimes a report will contain information about an employee's medical condition, but employers should not expect a detailed account of their medical history.

The purpose of the report is to provide relevant occupational advice, not to give the manager access to the employee's medical records.

In many cases, knowing the precise diagnosis is less useful than understanding its effect. A manager may need to know whether the employee is likely to experience fatigue, difficulty concentrating, restricted mobility or fluctuating symptoms, rather than every clinical detail about why those difficulties exist. The report should focus on information that is relevant to the employee's work and the questions the employer has asked.

Will Occupational Health Say Whether Someone Is Fit for Work?

It can provide an opinion about an employee's fitness for work. That might include advice that the employee is fit to continue working, could return with temporary restrictions or adjustments, or is not currently fit for their normal duties.

There is an important difference between medical advice and a management decision, though. For example, Occupational Health might advise that an employee could return if they temporarily avoid a particular duty. The employer then needs to consider whether that arrangement can actually be accommodated within the role and workplace.

Occupational Health provides the medical perspective. The employer still has to decide what is reasonably and practically possible.

What Does an Occupational Health Report Say About Adjustments?

This is one of the most useful parts of an Occupational Health report. The clinician may recommend adjustments that could help the employee remain at work or return after sickness absence. Depending on the circumstances, these might include altered hours, a phased return, changes to particular duties, additional breaks, equipment or changes to the working environment.

Recommendations are there to help the employer understand what may support the employee. That does not mean every recommendation automatically has to be implemented exactly as written. The employer needs to consider the recommendation alongside the requirements of the role, the workplace and any legal duty to make reasonable adjustments.

If a suggested adjustment cannot reasonably be accommodated, the employer should consider whether there are other ways of addressing the difficulty rather than simply ignoring the Occupational Health advice.

Does Occupational Health Decide Whether an Adjustment Is Reasonable?

No. Occupational Health can recommend an adjustment from a medical or occupational perspective, but whether an adjustment is reasonable under the Equality Act is ultimately a legal and employment question for the employer.

The clinician may be able to explain why a particular change would help the employee and how long it might be required. The employer then considers factors such as practicality, effectiveness, cost, resources and the impact on the organisation.

This is an area where managers sometimes become confused. A recommendation in an Occupational Health report should be taken seriously, but it is not the same as Occupational Health instructing the business how it must operate. Equally, an employer should not dismiss a recommendation simply because it is inconvenient.

Will Occupational Health Tell an Employer if Someone Is Disabled?

An Occupational Health report may give an opinion on whether the employee's condition is likely to meet the definition of disability under the Equality Act 2010.

That opinion can be very helpful, particularly where the effects of the condition are not immediately obvious. However, Occupational Health does not make the final legal determination about whether somebody is disabled. Ultimately, whether the Equality Act definition is met is a legal question.

Employers should therefore be careful about treating a sentence such as "in my opinion, the employee is unlikely to be covered by the Equality Act" as an absolute guarantee that disability law is irrelevant. The report is one piece of information the employer should take into account.

Can Occupational Health Tell You When an Employee Will Return to Work?

Sometimes, but not always. If the employee is recovering from an operation or a condition with a relatively predictable recovery period, Occupational Health may be able to give an indication of when a return could be expected.

Other conditions are much less predictable. Symptoms can fluctuate, treatment can take time to work and recovery does not always follow a clear timetable.

An Occupational Health report might therefore say that a return is unlikely within a particular period or recommend a further review rather than giving a definite return date. That can still be useful information. Employers do not necessarily need an exact date to start thinking about how an absence should be managed.

Can Occupational Health Tell You Whether Someone Will Be Able to Return to Their Role?

Yes, this is often an important question to include in the referral. Where an employee has been absent for a significant period or has a condition affecting their ability to carry out important parts of the job, Occupational Health may be able to advise on the likely longer-term outlook.

The report might consider whether the employee is likely to return to their full duties, whether restrictions may be temporary or permanent and whether there are aspects of the role they may no longer be able to perform.

That information can help the employer consider the next steps, including adjustments, rehabilitation, alternative work where appropriate or, in some circumstances, a capability process.

Does Occupational Health Decide if an Employee Should Be Dismissed?

No. Occupational Health should not make the employer's management decision. Its role is to provide medical advice that helps the employer understand the employee's health, prognosis and ability to work. Decisions about capability, continued employment or dismissal remain with the employer.

For example, an Occupational Health report might advise that there is little prospect of an employee returning to their substantive role within the foreseeable future. That could be important evidence in a capability process, but it does not mean the report itself gives the employer permission to dismiss the employee.

The employer still needs to consider the circumstances, consultation with the employee, reasonable adjustments where relevant, the medical evidence, possible alternatives and a fair process before reaching a decision.

What If the Occupational Health Report Doesn't Answer the Manager's Questions?

Sometimes a report comes back and the manager feels they know very little more than they did before the referral. That can happen because the clinician did not have enough information, the questions were too broad or the employee's condition simply does not allow for definite answers.

Start by looking back at the referral. Were the questions specific enough? Did Occupational Health have an accurate job description and understand the particular concerns?

If an important question has not been answered, it may be appropriate to go back to Occupational Health for clarification or further advice, subject to the appropriate consent and process. Managers should not fill gaps in medical advice with their own assumptions.

What Happens After an Occupational Health Report?

Once the report is received, the manager should read it alongside the reason the referral was made in the first place. Identify what Occupational Health has actually advised, what adjustments or restrictions have been suggested, what the prognosis is and whether any further review has been recommended.

Then discuss the report with the employee. An Occupational Health referral should not become a process where a medical report arrives and decisions are made about somebody without involving them.

The employee may be able to provide further context, explain what support they think would help and discuss how any recommendations might work in practice. From there, the manager can decide what action is appropriate, with HR advice where needed.

Occupational Health Advises, the Employer Decides

This is probably the simplest way to understand the purpose of an Occupational Health report. It can give an employer valuable medical advice about fitness for work, the effects of a health condition, prognosis, possible adjustments and an employee's ability to carry out their role.

What it generally cannot do is make the management decision. A useful Occupational Health report gives managers better information on which to base that decision. The employer then needs to take that advice, speak to the employee and decide what is fair, reasonable and workable in the circumstances.

Need HR Support?

If you're managing sickness absence, an Occupational Health referral or an employee returning to work with health concerns, BloomHR can help.

We provide practical HR advice to small businesses, including support with Occupational Health referrals, reasonable adjustments, absence management and capability processes. Contact us for more information.